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Crystal Lake Oral Maxillofacial Surgery Ltd
Oral and Maxillofacial Surgery (Dentist) in Crystal Lake, Illinois
NPI 1730197468

Crystal Lake Oral Maxillofacial Surgery Ltd is a Oral and Maxillofacial Surgery (Dentist) based in Crystal Lake, IL and is specialized in Oral and Maxillofacial Surgery. Crystal Lake Oral Maxillofacial Surgery Ltd practices in Crystal Lake, IL. The NPI Number for Crystal Lake Oral Maxillofacial Surgery Ltd is 1730197468 and holds a License No. 019018137 (Illinois).

The current practice location address for Crystal Lake Oral Maxillofacial Surgery Ltd is 690 N Il Route 31, Crystal Lake, IL and can be reached out via phone at 815-459-5600 and via fax at 815-459-5615.

Location: 690 N Il Route 31, Crystal Lake, IL, 60012-3790
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1730197468
Provider Name
Crystal Lake Oral Maxillofacial Surgery Ltd
Credential
Provider Entity Type
Organization
Address
690 N Il Route 31, Crystal Lake, IL, 60012-3790
Phone Number
815-459-5600
Fax Number
815-459-5615
Provider Enumeration Date
08/05/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
019025282 05 ID
019016621 05 IL
019018137 05 IL
019013457 05 IL
1700865441 01 NPI # DR. JOHN RICHARD
institution
Provider Business Practice Location Address Details
Address
690 N Il Route 31
City
Crystal Lake
State
Illinois
Zip
60012-3790
Phone Number
815-459-5600
Fax Number
815-459-5615
person
Provider Business Mailing Address Details
Address
690 N Il Route 31
City
Crystal Lake
State
Illinois
Zip
60012-3790
Phone Number
815-459-5600
Fax Number
815-459-5615
person
Provider's Taxonomy Details 1
Type
Dental Providers
Classification
Dentist
Speciality
Oral and Maxillofacial Surgery
Taxonomy
1223S0112X
License No.
019018137 (Illinois)
Definition
The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region.
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